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Organization

MEDICAL CENTER PRESCRIPTION SHOP

Active
Other names
Prescription Shop
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL FREDERICK DWOZAN RPH (CEO)
(478) 374-5514
Entity
Organization

Contact information

Practice address
710 MEDICAL CENTER DR, EASTMAN, GA 31023
(478) 374-5514
(478) 374-8617
Mailing address
710 MEDICAL CENTER DR, EASTMAN, GA 31023
(478) 374-5514
(478) 374-8617

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHRE006118
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00031864A
GA
Enumeration date
04/24/2006
Last updated
07/27/2025
About Stedi
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Product
  • Claims
  • Eligibility checks
  • EDI platform